Krista R Buchanan

Individual provider Active NPI Early Intervention Provider Agency · Effort, PA

NPI 1093109092 · NPPES record last updated Mar 27, 2015

Key facts

NPI
1093109092
Entity type
Individual (NPI type 1)
Primary specialty
Early Intervention Provider Agency 252Y00000X
License
3975912 (PA)
Practice address
1002 Cub CT
Effort, PA 18330-8035
Phone
(570) 656-4047
NPI assigned
Mar 27, 2015
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
3975912PAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Ecd Connections Multi-Specialty Past Accepting new patients
Sped Consulting & Therapy Multi-Specialty Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech/Language/Hearing Specialist/Technologist 235500000X 3975912 PA
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X 3975912 PA
Early Intervention Provider Agency 252Y00000X 3975912 PA Yes

Addresses

Primary practice location

1002 Cub CT
Effort, PA 18330-8035

Mailing address

PO Box 961
Effort, PA 18330-0961
Phone (570) 656-4047

Other identifiers

IdentifierTypeStateIssuer
0421880137-8OtherPAPROFESIONAL INSURANCE POLICY NUMBER
0421880137-8OtherPAINSURANCE POLICY IDENTIFYING NUMBER

Other providers in Effort, PA

All providers in Effort, PA · Early Intervention Provider Agency in Pennsylvania

Sources for this page

Verify at the official NPI Registry.